MEDICARE: SYSTEMS HEALTHCORP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	3336L0003X	Long Term Care Pharmacy	2783	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2815489	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1144231655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYSTEMS HEALTHCORP INC

Provider Business Mailing Address
First Line	:	3744 S 132ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68144-3608
Country	:	US
Telephone Number	:	402-339-4036
Fax Number	:	402-339-4081

Provider Business Practice Location Address
First Line	:	3744 S 132ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68144-3608
Country	:	US
Telephone Number	:	402-339-4036
Fax Number	:	402-339-4081

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ESSIEN EDET
Credential	:	RP
Telephone Number	:	402-339-4036

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	03/25/2010

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Directions to “SYSTEMS HEALTHCORP INC ” Practice Location

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